Occult toddler's fracture

This two-year-old girl fell off a caregiver's lap and presented with pain and limping. On the day of the injury, the radiograph of the tibia shows no fracture (A). She was placed in a controlled ankle movement walker boot. A follow-up radiograph three weeks later shows periosteal reaction along the tibial shaft (arrows) consistent with a toddler's fracture (B).